Healthcare Provider Details

I. General information

NPI: 1174296966
Provider Name (Legal Business Name): SUNG HOON CHO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TED CHO DMD

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 MOUNT HOPE AVE STE 8
ROCKAWAY NJ
07866-1646
US

IV. Provider business mailing address

800 PARK AVE APT 1901
FORT LEE NJ
07024-3775
US

V. Phone/Fax

Practice location:
  • Phone: 630-923-2666
  • Fax:
Mailing address:
  • Phone: 630-923-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13170
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: